The Electronic Cigarette

Manufacturers claim the e-cigarette is a healthier substitute for the tobacco cigarette, but when it is banned for retail sales by the Australian Government, who are we to believe?

A smoking hot discussion

Soaring in popularity with smokers on one hand, and shoved in a corner by the Australian Government on the other, the electronic cigarette is the subject of a smoking hot discussion between researchers and health organisations worldwide. Currently, retail sales of the e-cigarette are banned in Australia, and it can only be purchased through the Internet.

What is an electronic cigarette?

Thomas Kiklas, the American Co-Founder of The Tobacco Vapor Electronic Cigarette Association (TVECA), explained that: “the electronic cigarette or ‘e-cig’ is simply a battery that is attached to cartridge that contains 5 household ingredients (propylene glycol, glycerol, nicotine, water and flavourings). As the user inhales on the cartridge end the battery heats the constituents to create a vapour that is ingested to provide to the user their desired nicotine”. A World Health Organisation (WHO) Study Group on Tobacco Product Regulation stated in a 2010-report that electronic nicotine delivery systems are promoted under different brand names. They are unsure to the amount of manufacturers worldwide, but there are “at least 24 licensed companies and many more brands and model names”.

The electronic cigarette versus an ordinary cigarette

Office Manager of Elusion New Zealand Holdings Ltd, which manufactures electronic cigarettes, Charlotte McDonald explained that the differences between the two products mainly lie in the look of the two products. In addition to satisfying the physical habit, it can also cover nicotine addiction. “Differences are vast: the e-cigarette does not produce a smoke or need to be lit. It also does not contain many of the harmful chemicals found in a traditional tobacco cigarette. The e-cigarette also comes in a variety of flavours with the option of either red or blue light.”

Kiklas, well-groomed, wearing off-white shirt, stated that the electronic cigarette is comprised of the before-mentioned five common household constituents, which all “have been in the global food supply for generations and all have been approved for human dermal and inhalation use by the FDA [Federal Drug Administration] and EPA [Environmental Protection Agency]”. Kiklas was emphatic that “there have been over 20 studies of the e-cig and in none have [has] there ever been found any [a] toxin or carcinogen at any levels harmful to humans”. He further compared the non-existent levels of chemicals and carcinogens in the electronic cigarette, to a tobacco cigarette which has 6000 chemicals and 66 carcinogens.

On the other hand, professor Mike Daube, who is well known in the national and global health industry, disagreed. The man in the suit firmly and concisely stated that the e-cigarette “had no value, and we know little about the long-term consequences”. Gemma Vestal, Senior Adviser on Tobacco Product, Regulation, Legislation, and Enforcement of the Tobacco Free Initiative at WHO, supported Daubes’ opinion. With a noticeable European accent, she referred to conclusions made in the 6th meeting of the WHO Study Group on Tobacco Product Regulation, in Buenos Aires November 2010: “We don’t know enough about what toxins there are in the electronic cigarette so there are studies that need to be done.” She was of the opinion that the electronic cigarette should not be allowed onto the market before that is done. “Further studies needs [need] to be done before a country allows the marketing of these products, [and] the manufacturer, the owners of the work, has [have] proved that it’s a safe and effective product.” She stated that WHO’s research concludes that the e-cigarette cannot be used as replacement therapy for nicotine. However, she did say that: “After further studies, in ten years down the line, we might conclude that, you know, that it is a lot safer than regular cigarettes, but, you know, right now we can’t, we can’t endorse it”.

Susan Stewart from Cancer Council WA, found it difficult to make a direct comparison between the two types of cigarettes. “I think the thing about an electronic cigarette, that it’s not a product that the Cancer Council WA will endorse, for a variety of reasons.” With an air of experience, she said she had heard a promotional myth saying these cigarettes are supposedly healthier than a tobacco cigarette, which she sees as a part of the marketing of these products. Supporting Daube and Vestal, she quickly claimed that these products are not proved to be effective in terms of quitting.

Why “vape” an e- cigarette instead of smoking a traditional one?

McDonald said confidently that the e-cigarette is an alternative to traditional smoking. She stated that their current consumers give them positive feedback. Kiklas agreed, adding with enthusiasm: “the e-cig simply supplies adults with their desired nicotine without the aforementioned toxins and carcinogens associated with the smoking of cigarettes”. Smoker Andy Jensen, who has replaced his tobacco cigarettes with an e-cigarette, agreed that the e-cigarette is a much healthier alternative to tobacco. However, he mentioned a downside to it: the fact that you do not know the amount of nicotine to which you have inhaled. He said that the nicotine amount in one capsule is approximately the same as in 30 cigarettes. “I think it’s hard to count the number of inhalations when you smoke.”

Stewart firmly said the Cancer Council WA does not promote use of any of either of these products. “Those who are currently smoking should consider how they can quit, and to use the methods and services available for them.” She did not reckon that the e-cigarette adds anything into the range of options and strategies currently in use. She explained that, in most cases, people quit by themselves. Her opinion was supported by professor Mike Daube, who added that smoking is already declining in Australia. “Smokers quit by themselves, so the electronic cigarette would only be a distraction.”

Further, Vestal claimed it would be irresponsible for WHO to endorse the e-cigarette and claim that smoking it is safer than tobacco cigarettes. “We can’t say that it’s a safer alternative to cigarettes.” She repeated emphatically that: “we need further studies to be actually able to make that claim, and support any claims like that”.

Should the e-cigarette really be banned?

Since WHO does not know whether the e-cigarette is harmful or not, Vestal said that it is best to err on the side of caution and ban it for now. However, she pointed out that “we support the ban, not a permanent ban, but a temporary ban”.

Stewart, although on her side, supported a permanent ban. “The Cancer Council WA absolutely supports these cigarettes not being legally allowed to be sold in retail outlets. Those that contain nicotine cannot be sold because nicotine is scheduled as a poison, which [and] is tightly regulated. And if people are needing a product to containing nicotine, there are approved products on the market that has [which have] been rigorously tested, and which are approved for that purpose.”

On the contrary, smoker Jensen meant that there is no reason for the e-cig to be banned, when tobacco is allowed. “I think there’s some kind of corruption because the tobacco industry is still powerful,” he commented on the current ban. Further, McDonald said that the regulations are slightly complicated because the e-cigarette is a relatively new device. Right now, McDonald’s company is only allowed to ship the product to Australia for individuals’ use only, with up to a three-month supply of nicotine per shipment. McDonald said her company had received positive feedback from her current customers, and therefore felt that “the product should be freely available for those who are looking for an alternative”.

Kiklas stated: “The TVECA was founded to aggressively dispel the notion that the e-cigarette is nothing but five common household ingredients that work in harmony with digital technology to provide to adults the nicotine they desire in a much more logical convenience. For those that [who] believe the e-cig is hazardous, not studied or in any way not suitable as a very logical option for adults to the smoking of tobacco cigarettes that we know kill 18,000 Australians and 400,000 Americans annually, we say ‘follow the money’.” Kiklas referred to the anti- smoking groups ASH and American Legacy Foundation whom have taken hundreds of thousands of dollars from Pfizer. Kiklas explained that Pfizer are the producers of Chantix [Champix], a “stop- smoking pharmaceutical so hazardous the FDA had to produce a warning video for the American public”.

Professor Mike Daube is of the opposing side in this incendiary debate. He said that the e-cigarettes only are promoted by their producers to make money. Stewart supported him when she said that claiming these cigarettes are healthier than a tobacco cigarette is only part of a marketing strategy.

The future of the electronic cigarette – only a blast of smoke or a permanent trend?

When asked about what the future will bring for the electronic cigarette Vestal said that it could be proven a safe and good product after all. She informed me about a meeting conducted in Uruguay in Nov 2010, which was the 4th session of the Conference of the Parties (COP4) to the WHO Framework Convention on Tobacco Control. They specifically mandated the convention secretariat to ensure that the specific topic of electronic cigarettes is studied further. ”So, you know, once they find out more, they find out whether to regulate and how to regulate.” In the meantime, Vestal predicts that the producers have the opportunity to find regulatory gaps in many countries, which give them a lot of opportunities to market their products.

Stewart did not agree: “I wouldn’t think it’s a really good business prospect, because I just think it’s going into a market where a lot of strong evidence is required and they need to get that evidence before anything could happen.” She said that if she was to predict what would happen with the e-cigarette, she hopes it is a short-lived product.

Smoker Jensen meant the e-cigarette will dominate the marked. However, he was of the opinion that the e-cigarette will disappear in a few years, just as well as tobacco smoking.

On the other hand, McDonald saw a red-hot future for the e-cigarette. “It is already growing in popularity and I see this becoming a very commonly used product worldwide.” The TVECA agreed, and Kiklas confidently said he believed that in five years, smoking tobacco would seem odd. “In order to get to this realisation, journalists have to begin to stop reiterating very ignorant and/or purposely misleading statements for Health Advocacy Groups such as the WHO and governmental bodies, and begin doing their tasked duty to follow the truth and report on fact and science and not follow a personal or financial agenda to the detriment to the millions globally that [who] are using the e-cig as the option to the smoking of tobacco.”

As shown, there are many different perspectives on the controversial e-cigarette, and only the future will show which way the vapour is going to blow.